REMISSION OF SEIZURES AND PREDICTORS OF INTRACTABILITY IN LONG-TERM FOLLOW-UP
REMISSION OF SEIZURES AND PREDICTORS OF INTRACTABILITY IN LONG-TERM FOLLOW-UP
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DOI：
10.1111/j.1528-1157.1993.tb02114.x
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发表时间：
1993-09-01
期刊：
影响因子：
5.6
通讯作者：
SILLANPAA, M
中科院分区：
文献类型：
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作者：
SILLANPAA, M
在发病率队列中，对 178 名长期随访患者的缓解率和复发率及其决定因素进行了研究。对 40 名在过去 10 年的随访中有抗癫痫 (AED) 药物难治性癫痫发作史的患者进行了一项预测因素的比较研究，并与其他 138 名队列受试者进行了比较。将两组的 353 个变量进行交叉制表，包括家族史、产科史、发育史和癫痫病史，以及当前的医疗和社会状况。应用多变量分析来控制混杂因素。癫痫发作的明确或可能的远期症状病因、神经系统发育/状态异常、初始癫痫发作频率高、癫痫持续状态的发生以及 AED 治疗的短期效果不佳与长期 AED 无效显着相关。根据逻辑回归分析，AED 治疗的短期结果较差[比值比 (OR) 3.6； 95% 置信区间 (CI) 1.2-10.4]、癫痫持续状态的发生（OR 11.4；95% CI 3.2-41.0）、高初始癫痫发作频率（OR 4.6；95% CI 1. 1-19.3）和远期症状性癫痫病因（OR 2.9；95% CI 1.1-8.2）仍然是癫痫发作的唯一独立预测因素难处理性。这些因素有助于早期评估癫痫手术的必要性。
In an incidence cohort, remission and relapse rates and determinants were studied in 178 patients followed long-term. A comparative study of predictive factors was performed in 40 patients with histories of antiepileptic (AED)-drug-refractory epileptic seizures in the last 10 years of follow-up and compared with the other 138 cohort subjects. The two groups were cross-tabulated with 353 variables of family history, obstetric, developmental and seizure histories, and current medical and social status. Multivariate analyses were applied for control of confounding. Defined or probable remote symptomatic etiology of seizures, abnormal neurologic development/status, high initial seizure frequency, occurrence of status epilepticus, and poor short-term effects of AED therapy were significantly associated with long-term AED refractoriness. On logistic regression analyses, poor short-term outcome of AED therapy [odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2-10.4], occurrence of status epilepticus (OR 11.4; 95% CI 3.2-41.0), high initial seizure frequency (OR 4.6; 95% CI 1. 1-19.3), and remote symptomatic seizure etiology (OR 2.9; 95% CI 1.1-8.2) remained the only independent predictors of seizure intractability. These factors enable early assessment of need for epilepsy surgery.